November 13 2017. A presentation on November 5 at the 2017 American College of Rheumatology/Association of Rheumatology Health Professionals (ACR/ARHP) Annual Meeting in San Diego revealed a greater risk of end-stage kidney disease among systemic lupus erythematosus (SLE) patients who were low in vitamin D. Systemic lupus erythematosus is an autoimmune disease, in which the body attacks its own tissues, leading to organ damage.

“Vitamin D insufficiency/deficiency is common in SLE,” write Michelle A. Petri, MD, PhD, and colleagues at Johns Hopkins University School of Medicine. “Replacement therapy may help renal disease activity.”

The team analyzed data from 1,392 lupus patients with information available concerning their 25-hydroxyvitamin D levels. Follow-up clinic visits documented organ or tissue damage. Twenty-three percent of the subjects were categorized as having abnormally low vitamin D levels of less than 20 ng/mL at the time of the first office visit at which levels were measured.

The relative risk of kidney damage was the highest for SLE patients in the low vitamin D group, whose risk was 87% higher than that of sufficient subjects. Those with low vitamin D levels also experienced a greater risk of skin and total organ damage.

"Supplementing vitamin D reduces urine protein, which is the best predictor of future renal failure," commented Dr. Petri, who is the Director of the Hopkins Lupus Center. "Supplementary vitamin D is very safe. It helps to prevent one of the most dreaded complications of SLE, and likely has a role in preventing blood clots and cardiovascular disease as well. Vitamin D supplementation, which can reduce proteinuria, should be a part of the treatment plan for lupus nephritis patients."